The present invention relates to medical examination, diagnosis and treatment, and more particularly, to providing such services over a network.
Health care costs in the United States exceed one trillion dollars per year. In 1996, spending on health care in the United States exceeded fourteen percent of the Gross Domestic Product. Current health care system costs include annual service to over ninety million people in over five thousand hospital emergency departments. These ninety million or more visits impose an enormous burden on emergency departments. Ambulances on route toward the closest available emergency department are often diverted to other hospitals, sometime located in another city. The cause of such calamities is multi-factorial and includes: nursing shortages, bed unavailability, and grossly overcrowded, overburdened emergency rooms.
Telecommunications technologies, and in particular, video-conferencing, offer an opportunity to provide cost effective care in a variety of settings. In particular, tele-medicine and tele-healthcare have been envisioned with respect to many specialties including: pathology, dermatology, surgery, opthamology, cardiology, and radiology. However, diagnosis and treatment in these areas require either a human presenter or mechanical equipment at the patient end to gather pertinent information related to the patient""s condition.
For example, it is known in the prior art to provide remote monitoring of patients over a network. U.S. Pat. No. 5,544,646, which is hereby incorporated herein, issued to David et al., discloses an interactive television and audio patient monitoring system for connecting a patient situated at home or in a hospital room with a central monitoring station that is manned by one or more health care practitioners. The invention provides two-way interactive visual communications between a patient and a health care practitioner via cable television lines whereby the central station may continuously monitor one or more medical parameters (such as, ECG, blood pressure, respiration, etc.) by utilizing medical equipment located in the patient""s hospital room or home.
Similarly, U.S. Pat. No. 5,810,747, issued to Brudny et al., and also incorporated herein by reference, discloses an interactive training system used for monitoring a patient suffering from neurological disorders of movement. The system includes a patient station that includes a computer in communication with a supervisor station via a local area network or the Internet. Sensors collect physiologic information and physical information from the patient while the patient is undergoing training. This information is provided to the supervisor station to be summarized and displayed to the patient and the supervisor.
U.S. Pat. No. 6,168,563, issued to Brown and incorporated herein by reference, discloses a system and method for enabling a health care provider to monitor and manage a health condition of a patient. The system includes a health care provider apparatus operated by a health care provider and a remotely programmable patient apparatus that is operated by a patient. The health care provider develops a script program using the health care provider apparatus and sends the script program to the remotely programmable patient apparatus through a communication network such as the World Wide Web. The script program is computer executable, and provides information to the patient about the patient""s health condition by asking the patient questions and receiving answers to the questions. The answers are forwarded to the health care provider through the communication network and processed for further management of the patient""s health condition by the health care provider. The patient data may also include information supplied by a physiological monitoring device that is connected to the remotely programmable patient apparatus.
In addition, U.S. Pat. No. 6,205,716, issued to Peltz and also incorporated herein by reference, discloses a secure, modular interactive two-way tele-collaborative video conferencing and imaging enclosure for remotely monitoring physiological attributes of a user by medical specialists and remote interaction between users and medical specialists. Access to the system requires participation in a healthcare program or health insurance program, such as an HMO. The healthcare program provides the patient with an xe2x80x9caccess cardxe2x80x9d that enables the patient to use the enclosure.
In a first embodiment of the invention there is provided a method for delivering medical examination, diagnosis, and treatment services from a physician to a patient over a network. The method includes providing a physician call center that enables any of a first plurality of physician terminals to be in audiovisual communication over the network with any of a second plurality of patient terminals; receiving a call at the call center from a patient at one of the patient terminals; routing the call to an available physician at one of the physician terminals such that the available physician may carry on a two-way conversation with the patient and visually observe the patient; and permitting the available physician to make an assessment whether the patient may be suffering from an acute non-urgent condition; and to conduct an examination of the patient over the network, including by a visual study of the patient, only if the assessment is that the patient may be suffering from an acute non-urgent condition.
In accordance with a related embodiment of the invention, the method may further include having the patient stand in the course of the examination, so as to provide a basis for a gross evaluation of patient condition.
In accordance with further related embodiments of the invention, making an assessment may include making an assessment in accordance with a protocol and the protocol may optionally be stored in a database. A relevant segment of the protocol may be displayed in real time to the available physician, and the relevant segment may include an electronic link to a third party such as a primary care physician, specialist, hospital, emergency room, ambulance service, clinic, or pharmacy. The electronic link may include a hypertext link.
In accordance with other related embodiments of the invention, permitting the physician to prescribe a treatment may include permitting the physician to refer the patient to a third party for treatment, and the third party may be a primary care physician, specialist, hospital, emergency room, ambulance service or clinic. Permitting the physician to prescribe a treatment may also include, when a treatment is being prescribed by a physician, communicating a prescription over the network to a pharmacy via an electronic link. The electronic link may be included in a relevant segment of a protocol that is contained in a protocol database resident on a digital storage medium. The electronic link may be a hypertext link or another communication link or device (e.g., telephone computer, facsimile etc.). Instructions pertaining to the treatment of the patient may optionally also be communicated to the pharmacy in similar manners.
In accordance with yet another related embodiment of the invention, permitting the physician to conduct the examination is accomplished under conditions such that the examination is conducted without medical instruments at the patient terminal where the patient is located.
In a further embodiment of the invention, there is provided a system for delivering medical examination, diagnosis, and treatment services from a physician to a patient over a network. The system of the embodiment includes a first plurality of physician terminals, each of the first plurality of physician terminals including a display device, and a second plurality of patient terminals in audiovisual communication over a network with any of the first plurality of physician terminals. The system also includes a physician call center in communication with the patient terminals and the physician terminals, wherein the physician call center routes a call from a patient at one of the patient terminals to an available physician at one of the physician terminals, such that the available physician may carry on a two-way conversation with the patient and visually observe the patient. The system further includes a protocol database resident on a digital storage medium, accessible to each of the physician call terminals. The protocol database contains a plurality of protocol segments such that a relevant segment of the protocol may be displayed in real time on the display device of the physician terminal of the available physician for use by the available physician in making an assessment whether the patient may be suffering from an acute non-urgent condition. The protocol database may be resident on a server that is communication with each of the physician terminals. Similarly, each of the physician terminals may include a local storage device and the protocol database may be replicated on the local storage device of one or more of the physician terminals.
In accordance with a related embodiment of the invention, the system may optionally include a patient database accessible to each of the physician terminals for storing patient information, and the patient information may be displayed on the display device of the physician terminal of the available physician. The system may further include a medication database, accessible to the each of the physician terminals, for storing medication information.
In accordance with a further related embodiment of the invention, each patient terminal may be configured to permit the available physician to conduct an examination of the patient, including by visual observation of the patient, while the patient is standing.
In accordance with yet another embodiment of the invention, a system for delivering medical examination, diagnosis, and treatment services from a physician to a patient over a network includes a first plurality of physician terminals, each of the first plurality of physician terminals including a display device; and a second plurality of patient terminals in audiovisual communication over a network with any of the first plurality of physician terminals. One or more of the second plurality of patient terminals is configured such that unrestricted access to the patient terminal is permitted. The system further includes a physician call center in communication with the patient terminals and the physician terminals. The physician call center routes a call from a patient at one of the patient terminals to an available physician at one of the physician terminals, so that the available physician may carry on a two-way conversation with the patient and visually observe the patient.
In related embodiments, the system may also include a protocol database resident on a digital storage medium, accessible to each of the physician terminals, wherein the protocol database contains a plurality of protocol segments such that a relevant segment of the protocol may be displayed in real time on the display device of the physician terminal of the available physician for use by the available physician in making an assessment whether the patient may be suffering from an acute non-urgent condition.
In further related embodiments, the relevant segment of the protocol displayed in real time on the display device of the physician terminal includes an electronic link that establishes communication between the available physician and a third party, and the third party may be one or more of a primary care physician, specialist, hospital, emergency room, ambulance service, clinic or pharmacy. The electronic link may include a hypertext link.
In still further related embodiments, the system may include a patient database accessible to each of the physician terminals for storing patient information, and the patient information may be displayed on the display device of the physician terminal of the available physician. The system may also include a medication database accessible to each of the physician terminals for storing medication information. Each patient terminal may be configured to permit the available physician to conduct an examination of the patient, including by visual observation of the patient, while the patient is standing.
In accordance with other related embodiments, each patient terminal may include a telephone such that a patient may establish a direct connection to the physician call center by picking up the telephone receiver. Further, the protocol database, the patient database, the medication database, or any combination thereof, may be resident on a server that is in communication with each of the physician terminals. Similarly, each of the physician terminals may include a local storage device and the protocol database, patient database, medication database or any combination thereof may be replicated on the local storage device of one or more of the physician terminals.